Migraines

Migraine is a neurological condition that can cause multiple symptoms.

A migraine attack is frequently characterized by a severe throbbing pain or a pulsing sensation, which usually begins on one side of the head, in the forehead, or around the eyes. The headache gradually gets worse and is often accompanied by nausea, vomiting, difficulty speaking, numbness or tingling, and extreme sensitivity to light and sound.

Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with a person’s daily activities.

Migraine symptoms

Migraines often begin in childhood, adolescence, or early adulthood, and women are more likely to suffer from chronic migraines (defined as 3 months of at least 15 days of headache a month).

Fatigue, food cravings, lack of appetite, mood changes and even symptoms that resemble a stroke, such as tunnel vision, tingling or numbness on one side of your body, speech impairments and more can all be experienced before a migraine attack.

An attack often begins as a dull ache and grows into throbbing pain, which usually gets worse during physical activity and often cause nausea and/or vomiting.

Migraines might occur rarely or strike several times a month. How often they occur varies from person to person.

Causes of migraines

Though migraine causes are not fully understood, genetics and environmental factors appear to play a role. Family history is, in fact, one of the most common risk factors for having migraines.

Current thinking is that a migraine starts when overactive nerve cells send out signals that trigger your trigeminal nerve, which gives sensation to your head and face. This cues your body to release chemicals that might cause imbalances in the brain and swelling of blood vessels, hence causing inflammation and pain.

Migraines treatments

Traditionally, there are two main types of migraine treatments.

The first one is for mild to moderate migraines, when over-the-counter medicines may be sufficient to help relieve migraine pain. Providing they are taken as soon as the person is feeling an attack coming, they should stop the headache from becoming severe.

The other type of treatment is for people who have more severe migraines and involves prescription medicines that are taken every day to reduce how often headaches occur.

But when it comes to chronic migraines, which are defined as 3 months of at least 15 days of migraine headache a month, these traditional treatments might fail.

Fortunately, there’s a third type of treatment that can be performed by Dr Nina Bal’s expert hands at her Facial Sculpting clinics to alleviate symptoms of the most severe cases of migraine.

This treatment involves the use of a neurotoxin called Botulinum Type A, commonly used for non-surgical facial aesthetic treatments to reduce wrinkles and the signs of ageing.

Using botulinum toxin for treating migraines

A few years ago, it was noticed by chance that people having cosmetic treatments with botulinum toxin also had fewer headaches.

When botulinum toxin gets injected into the muscles, it blocks signals from the nerves to the muscles. So when facial expression muscles are injected, they stop contracting and that makes wrinkles relax and soften.

In the same way, botulinum toxin gets into the small nerves that carry pain from the head to the brain, known as C-fibres. This reduces the amount of chemicals released from the nerve ending and therefore interrupts the feedback pathway that perpetuates migraine and headache.

Today, botulinum toxin injections are proven to work for chronic migraine. The treatment is also used to cure other illnesses, including hemifacial spasm, dystonia, cerebral palsy, and stroke.

How does the treatment work

Botulinum toxin is given as a series of tiny injections under the skin or into the muscles in and around the forehead, above the ears, and into the neck and shoulders.

The injections are repeated every 12 weeks until the patient no longer has chronic migraine. Normally, improvements should be seen after the first or second set of injections.

Results

The effect of botulinum toxin on nerves takes anything from several days to a few weeks to work. You should not expect chronic migraine to improve properly in less than 4 weeks. Some patients do not start to improve until after their second set of injections which is given 12 weeks after the first set of injections.

The goal of this treatment is not to become completely free of headache or migraine, but to improve quality of life, converting migraine from chronic to episodic. Studies show that 47% of patients had a 50% or greater reduction in the number of days with headache.

Possible side effects

Side effects relating to the spread of botulinum toxin far away from the injection site have been reported very rarely.

The injections are slightly prickly or stingy and take about 5 minutes to complete, after which you can return to your normal activities.

Treatment with botulinum toxin is not suitable for pregnant or breastfeeding women, and can only be administered for chronic migraines and is subject to previous consultation with Dr Nina Bal.